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Recognising benign skin lumps
1. Demonstrate an ability to recognise and distinguish common benign skin lumps including: Moles; Freckles; Dermato-fibroma; Pyogenic Granuloma; Seborrheic Keratosis and Haemangioma 'Moles a.k.a. melanocytic naevus' Moles are a proliferation of melanocytes. Naevi may be congenital or acquired - usually in childhood. The number of moles usually stabilises in the sixth decade. There are three main subcategories of moles: *''Intradermal naevi'', which exist solely in the dermis layer. They are frequently non-pigmented, and often occur on the face. *''Junctional naevi, which are confined to ther dermo-epidermal junction. They are macular in shape. *''Compound naevi, ''which are a combination of the above two subcategories Some naevi are given specific names: *''Giant congenital naevi ''are >20 cm in diameter, and 5% will undergo a malignant change. They must be carefully monitored for sudden change in size, colour, border, or new satellite lesions. *''Mongolian blue spots ''are large, macular lesions usually found on the back. They are commonly found in darker skin types such as Asian or black. Their presence must be formally documented, as they can occasionally be mistaken for a bruise. *''Blue naevus ''is formed of deeply pigmented melanocytes situated deep in the dermis, giving a "slate blue" appearance. *''Spitz naevus '' is a fleshy pink papule, which is found in children. They have a classic dome shaped appearance and usually grow rapidly up to 1 cm in size. *''Halo naevus ''is a mole with a surrounding area of depigmentation. The depigmentation is thought to be caused by autoantibodies against melanocytes, which may cause the naevus to disappear entirely. Some people may have several halo naevi simultaneously *''Becker naevus ''is an area of increased pigmentation, often associated with hair growth, usually on the upper thorax or shoulders. 'Freckles a.k.a. Lentigines' Freckles are small, macular, well-defined macules that occur on sun-exposed skin. They are more common in fair skin types, and range in colour from light tan to almost black. 'Dermato-fibroma a.k.a. histiocytoma' Dermatofibroma is a benign overgrowth of fibrous tissue in the dermis. They are seldom more than 1cm in diameter. Their colour ranges from pink to brown, and they move with the skin. The overlying skin may be tethered, causing it to dimple when pinched. The skin over the surface is generally smooth, but can become scaly. Distinctively, they are firm on palpation. 'Pyogenic Granuloma' Pyogenic granulomas are highly vascularised, well-circumscribed lesions, rarely more than one centimetre across. They grow rapidly and bleed easily. Lesion sites may be associated with an area of previous trauma. They can be protruberant or pedunculated, with a shiny, moist surface. 'Seborrheic Keratosis a.k.a. seborrhoeic warts' Warts may be barely palpable, protuberant or pedunculated. They vary from 0.5 - 3 cm in diameter. They are highly variable in terms of their colour, ranging from pale tan to dark brown. They have a greasy appearance, a warty, dull surface and well-circumscribed edges. They can cause anxiety of malignancy, especially as they occasionally become inflamed, and they mostly appear in the later stages of life. '(Cavernous) Haemangioma a.k.a. strawberry naevus''' A highly vascularised, nodular swelling, most commonly found on the head and neck.